THE use of physical restraint, seclusion and rapid tranquilisation have been dramatically reduced by a mental health ward in Southampton.

Following its involvement in an improvement programme led by the Royal College of Psychiatrists, Stewart ward in Bluebird House, Southampton, reduced their use of restrictive practices by 67 per cent - cutting their average monthly use from 76.4 to 25.2 – far exceeding the national aim of 33 per cent.

So called "restrictive practices" – used in mental health inpatient settings to protect the person restrained and others from harm – is an area of care that has proven difficult to improve in recent times, with over 100,000 instances in England last year.

Methods of care including giving patients more leave from the ward, and increasing the number of activities for patients have all contributed to the ward's success.

Dr Amar Shah, national lead for the Mental Health Safety Improvement programme, said: “We’re really proud of everyone at Stewart ward who has contributed to achieving these outstanding results.

“They’ve shown that dramatic improvements to quality of care can happen when staff and service users have the freedom to come together to develop and test creative ideas.

“This is the first time we’ve used quality improvement at national scale in England, and Stewart ward demonstrates how effective this can be.

“The college has produced free resources which will enable mental health wards across the country to learn from this work, and test out the ideas that have been shown to make a difference in reducing the use of restrictive practices.”

The programme used a new way of improving patient care and services called Quality Improvement (QI). It focuses on involving those closest to the issue – frontline staff, service users and carers - to identify and test new ideas and uses data to understand which ideas are working.

NHS data[i] shows there were 104,931 recorded cases of restrictive interventions in England in 2018-19, including 10,545 instances of people held in the prone position and 62,337 other types of physical restraint. Patients were kept in seclusion rooms on 9,568 occasions and tranquilised 10,759 times.

The Reducing Restrictive Practices programme, which launched in November 2018 and concluded in March 2020, aimed to reduce the use of restrictive practices by one third in 38 wards across 25 mental health trusts.